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Not every meniscal tear requires surgery. Most doctors, physicians and orthopedic specialists will recommend conservative therapy for minor meniscus injuries before considering surgery. If not dealt with properly, your knee and meniscus could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
Some conservative treatment methods recommended include:
- Rest - This is important for initial healing because without an correct amount of rest you are at risk for increased inflammation, pain and re-injury of your meniscus.
- Cold Compression - Immediate cold compression (using the Knee Freezie Wrap®) will allow you to manage pain while getting rid of swelling, inflammation and edema in your knee.
- Blood Flow Stimulation Therapy™ (BFST®) - You can use your own blood flow to maximize your rehabilitation, decrease recovery time, and boost overall long-term healing.
Other Conservative Treatment Methods can be Risky
In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections will reduce your pain, but a greater cost. The cortisone reduces your inflammation, the same inflammation increases the blood supply that is trying to heal the damaged meniscus tissue. You will be turning off the healing power to the meniscus.
"Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the tendons, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent. The long-term side effects also include elevation of blood pressure, thinning of bones (osteoporosis) and a rare but serious damage to the bones of the large joints (avascular necrosis)." (reference: American Academy of Orthopaedic Surgeons and Webmd.com)
One major side effect of repeated cortisone shot treatment is degeneration of cartilage in the knee joint. This itself is the fact, many doctors will limit the number of cortisone shots that you are allowed to have. Unless you have a chronic inflammatory condition like rheumatoid arthritis, you will be limited to a maximum treatment of 4 cortisone shots to the same area of your body. The benefits of cortisone shots are also known to reduce after each injection that you have because your body gets used to the synthetic solution.
(source: American Orthopaedic Soctiey for Sports Medicine and Mayo Clinic)
There are risks associated with regular use of a knee brace, especially if the brace you are using is not a custom fitted/design. If you are using a standard or "off the shelf" knee brace then it is possible that the brace is not the right size, positioned incorrectly on your knee, or even causing more damage to your injury. Knee braces can also feel heavy or bulky at first if you are not used to wearing one. It is possible that you may not feel the benefits of wearing a knee brace for a month, or however long it takes for you to feel comfortable wearing your brace. Skin irritation can also occur under the brace depending on the breathability of the material you are using for your knee brace and the overall fit. One important thing to be aware of is the amount of restriction you are placing on your knee while wearing a knee brace. Too much restriction in movement for an extended period of time can result in stiffness of your joint, chronic pain, or wasting away of the ligaments, tendons and muscles in your knee and leg.
Safe, Effective Conservative Treatment Options are Available
If your physican has decided that your injury can be treated with conservative treatment, you can join our many customers who have had great success treating themselves with the powerful, conservative treatment products we offer through AidMyMeniscus - the Knee Freezie Wrap®, Inferno Wrap® and the Knee-Flex® Passive Heel to Hip Stretching Device.
If surgerical intervention is required, talk to your physican about using these same products for post-surgery recovery as you will find them to be effective for reducing post-surgery inflammation, enhancing range of motion and minimizing scar tissue growth.
If Surgery is Required...
The type of surgery you will have depends on the type of injury you are faced with.
If you have undergone surgery on your meniscus then your physician will quickly get you on the path to rehabilitation. Now, the aggressiveness of the rehabilitation efforts will depend on a variety of factors including (but not limited to): your age, the state of your injury before surgery, the location of the meniscus tear (is enough blood supply available?) and how soon will you return to normal activity.
Usually, for quicker rehabilitation a partial meniscectomy will be performed. For meniscal repair surgery, however, the rehabilitation efforts can vary widely. It's important to be aware of the risks you may face with any procedure intended to fix or relieve pain from your meniscus injury.
It is quite common to have a tendon or liagment injury at the sametime as a meniscus damage. The type of surgery you require will depend on the size, shape and location of your meniscus injury.
When it comes to meniscus surgery there are common procedures that are used to treat your meniscus tear. If it has been determined by your doctor, physician or orthopaedic surgeon that you require meniscus surgery to fix your meniscus tear, they may fix your meniscus with one of the following surgeries:
- Open Knee Surgery
- Arthroscopic Meniscal Repair Surgery
- Arthroscopic Partial Meniscectomy Surgery
- Arthroscopic Meniscal Replacement Surgery
Surgery is typical done arthroscopically while under some type of anesthesia; they usually don't require an overnight hospital stay. Your orthopedic surgeon will determine which surgery is most suited to your condition. There are rare cases that during surgery your surgeon may have to change and do open surgery to correctly repair all the damage to the tissue in the knee.
Open Knee Surgery
Open knee surgery is considered to be an older surgical technique used when arthroscopic surgery was not available. Open surgery is not typically performed because of the greater tissue trauma to the larger surgical incisions. The surgeon would open up your knee to view the joint and tissue within by creating an incision 6 to 10 inches in length. This means that the surgeon must cut through your skin and/or separate muscle, tendons or liagments underneath, all while avoiding major blood veins and nerves to get a complete visual inside of your knee.
Open knee surgery can take anywhere between 30 minutes to 2 hours depending on the amount of work needed to fix your knee and meniscus. During this time you will be placed under general anesthesia to put you to sleep. If there is no open wound in your knee, the surgeon will mark the area they intend to cut into. A tourniquet will be placed just above your knee to prevent swelling and fluid accumulation during the surgery. You will have to stay overnight or maybe even longer in the hospital after your surgery. This allows your surgeon and other doctors and nurses to closely observe your condition after surgery. They will provide stronger medication through your IV to ease your pain and make sure you have no chance of infection or complications after the surgery.
Recovery from open knee surgery is much more extensive than recovery from an arthroscopic surgery. Notable complications, such as blood clotting and infection, are higher risk factors during an open knee surgery versus an arthroscopic procedure. As with any surgery, it is important to discuss all possible complications with your orthopaedic surgeon before the procedure.
Arthroscopic Meniscus Knee Surgery
The size and location of the tear as well as activity level are taken into account when determining if arthroscopic surgery is right for you. Arthroscopic procedure is done with 2 to 4 small keyhole incisions approximately 4 to 5 mm in length, a thin tube containing a camera and light inserted through an incision near the knee joint. This type of surgery will provide the surgeon with first hand look into the nature of the injury and possibly limit the amount of knee damage from surgery, helping promote a more effective recovery. Some tears however, will require open knee surgery as the scope of arthroscopic surgery is limited in comparison to full exposure of the meniscus in open surgery.
You will also be prepared for surgery with local, regional or general anesthesia. Local anesthesia focuses on numbing your knee; regional anesthesia numbs you below the waist while general anesthesia puts you to sleep. During arthroscopic surgery, a tourniquet will be placed above your knee to prevent swelling and fluid build-up. Surgical instruments are then inserted through these incisions. Your surgeon will insert the instruments required which may include probes, scissors, shavers or lasers. In order to view your inner knee joint and have enough room to move around, your surgeon will inject a saline solution into your knee. The knee will expand space is created between your femur and tibia.
If your meniscus tear is a similar shape, size and in a location that your surgeon already expected, you qualify for a meniscal repair, and the repair of your tissue will be performed. The surgeon will take 1 to 2 hours to complete arthroscopic meniscus repair surgery. You are considered to be an outpatient procedure, so most of the time you will be able to leave the hospital the same day as your surgery.
Only about 10 - 15% of meniscus tears are repairable, and in most of those cases the meniscus is repaired along with other tissue in the knee (such as the anterior cruciate ligament or ACL). If your orthopaedic surgeon has decided that you qualify for a meniscal repair procedure, your surgeon may fix your meniscus with one of the 3 techniques available to fix a meniscus tear:
- Inside-Out Repair, incisions are made in the skin to the inner-most side and outer-most side of your knee just below the knee cap. This technique is mostly used for meniscus tears located closer to the posterior horn (back of your knee) and mid-body (middle) of the meniscus.
- Outside-In Repair, the outside-in repair technique is similar to the inside-out repair technique, but the sutures start on the outside of your knee. This technique is only used for meniscus tears that are located on the anterior horn of your meniscus.
- All-Inside Repair, this technique is best for any tears located closer to the posterior horn of your meniscus, or nearer to the back of your knee. Repairs with this technique are limited to tears that are 2 to 4 mm in size.
Before your surgeon uses one of these techniques to fix your meniscus tear, they will perform additional work called debridement and abrasion to prepare your tissue for the repair. Debride of your meniscus tear is done in order to remove dead, hardened, or contaminated tissue. If you have an open wound the removal of any foreign substances found in the knee will be done. Your surgeon will then scrape down and smooth out (abrade) your tissue to make it easier for the edges of your tear to come together. Abrasion can also trigger bleeding of your meniscal tissue. Bleeding in your meniscus is something that your surgeon wants to happen because it will stimulate healing of your meniscus after the surgery.
The technique selected for your surgery can greatly influence the healing response of your meniscus to the surgery. The right technique for your tear can increase your meniscal stability and speed your overall recovery.
A meniscal repair is generally preferred over a meniscectomy, as it fixes the damage and helps prevent total brake-down of your meniscus. However, this involves a more complex surgery, the recovery is longer and it is not always possible (depending on the location). Early diagnosis affects the outcome of this surgery. Younger people tend to be the best candidates as their tears are often stable and located near the outer blood rich area of the meniscus. These tears have a better chance of healing than those farther in the joint because of the blood supply
Trepanation (Abrasion Technique) involves making small holes or shaving torn edges in your meniscus to promote bleeding and enhance healing. Longitudinal tears or bucket handle tears often won't heal unless they are abraded.
Suturing involves using stitches to reconnect the tear, repair the damage, and save your meniscus. The sutures are spaced 3-4 mm apart to prevent gapping and sewn while your knee is fully extended (or at 10 degrees maximum) to allow for full extension after surgery.
We have tools that will help you with post-surgery meniscus pain, healing and stretching. When it comes to your injured knee, it's best to start effective long term healing right away. Our Advisers are highly trained individuals and will help find the long term healing goal that's right for YOU. AidMyMeniscus advisors do not work on commission, so be assured you will only receive fair and objective information. Why wait?
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Arthroscopic Partial Meniscectomy Surgery and Full
Partial removal of the meniscus will depend on the tear factors; location, the way it is torn, the length, condition of the entire knee, condition of the entire meniscus, your age and any related degeneration (such as arthritis). It is generally used for degenerative and horizontal tears located in the inner 2/3 of your meniscus (the white-on-white zone). This area has a poor healing rate because it receives little or no blood supply, therefore it is better to remove the damaged part rather than try to fix it. The goal of this surgery is stabilization, which will prevent catching, buckling and locking in your knee joint. The surgeon will trim and smooth out frayed edges on the inner rim (which can be difficult to reach), and remove the damaged part or flap of your meniscus. You should be aware that long term degeneration of the knee is more likely the more meniscus tissue is removed, and your surgeon will try to save as much of the meniscus as he/she as possible.
Full meniscectomy may be required if there is extensive damage to the meniscus and it is determined unsalvageable. Removal of the meniscus can lead to joint narrowing, ridging, flattening, and becoming bow-legged or knock-kneed. Once the meniscus is removed there is much less cushioning in your knee and as less stability (resulting in a 200%-350% increase in contact pressure). A full meniscectomy is more common in elderly patients than young and active patients, as the impact of a fully meniscectomy will last for lifetime and can be a big impact on one with an active lifestyle. Studies have shown that over 75% of patients that have undergone a partial meniscectomy have been able to go back to doing what they did before their meniscus injury.
Although meniscectomies have faster recovery than other meniscus surgeries they can often lead to arthritis as the size of your meniscus (shock absorber) is reduced and/or removed. Normal knees have 20% better shock-absorbing capacity than meniscectomized knees.
An arthroscopic partial meniscectomy will usually take 1 to 2 hours to complete. It is also an outpatient procedure, so you should be able to leave the hospital the same day as your surgery. Post-surgical recovery of a partial meniscectomy is much quicker than rehabilitation for a meniscal repair. Once your torn meniscus tissue is removed your symptoms should ease and you will be able to return to your regular activities (work or athletics) within 1 to 2 months.
Knee stability after meniscus surgery
The load distribution across the knee will be directly related to the amount of meniscus that is removed during surgery. With less meniscus tissue between the upper and low leg bones, the joint will be less able to handle heavier loads. The uneven load distribution caused from the reduction in meniscus tissue, may increase knee degeneration in the joint. The lack of stability and often accompanied with pain while walking, running and jumping and may require you to wear a brace or use crutches. Overall, the knee is less likely to be as active as it once was and often this is how joint degeneration begins. Regular use of the Knee Freezie Wraps®, Knee Inferno Wraps® and the Knee-Flex® Passive Knee Stretch Device will help lessen the chance and/or severity of knee joint degeneration and in some cases, our customers have prevented the onset of degeneration through regular use of these treatments.
In the case of a discoid meniscus that did not heal through conservative treatments, part of your meniscus may be removed to relieve symptoms, prevent further tearing and preserve some of your meniscus cushioning function.
Red Zone versus White Zone
Doctors call the outer third area of the meniscus the Red Zone. This is the area of the meniscus that receives the most blood flow. The inner two-thirds area of the meniscus is deemed the White Zone and this is the area of the meniscus that receives very little blood flow. If you have read through this website, you will know that bloodflow is essential for healing - as such, the White Zone of the meniscus is troublesome as this area does not heal very well.
Blood Flow Stimulation Therapy™ is very effecting at increasing your own natural healing ability. Especially when the meniscus has such a small blood supply and such a poor healing rate. To read more about this fast and easy to use Blood Flow Stimulation Therapy™ Knee Inferno Wrap® CLICK HERE.
Arthroscopic Meniscal Replacement Surgery
In early medical practices the menisci were thought to be pieces of tissue that had no function in the knee. This school of thought, many doctors and surgeons would regularly remove an entire meniscus in order to treat the pain from the symptoms their patient experienced. Medical practices do evolve over time, and now so much more is known about the function of our menisci and how important they truly are. Now it is also obvious why those who have previously had a full meniscectomy are experiencing so many long-term chronic symptoms. Meniscus removal may have bone spurs that have developed around their femur as well as a narrowed joint capsule and a degenerative condition such as arthritis or osteoarthritis (OA).
This procedure is still considered to be experimental in nature and there are few people who qualify for this surgery. In order to qualify you must meet the following criteria:
- You have already had a full meniscectomy (you are missing an entire section of meniscus in your knee) or a complex degenerative meniscus tear.
- You are a young (less than 50 years old) and physically active individual.
- You do not have a significant amount of arthritic damage in your knee.
- You have very little degeneration of articular cartilage surrounding your femur and tibia as well as absolutely no evidence of cracks on your bones.
- You have stable, healthy ligaments in your knee with normal alignment of your knee joint. The alignment of your knee will be assessed before the surgery with physical examination.
If you do not meet this set of criteria, your doctor or surgeon may feel that there are too many chances for a negative outcome and so they will not perform this surgery. Your surgeon will only consider this procedure if they think you will experience the best possible results from this surgery.
A meniscal replacement involves implanting a new meniscus into your knee. There are two different replacements that can be used:
An allograft is a transplant from a donor. A good candidate for this type of replacement is someone who is young, has minimal ACL damage, is a previous menisectomy patient, and has developed pain in the knee capsule. If you are obese, suffers from gout or arthritis, has an infection or any metabolic disease (being unable to convert food to energy) they are not likely candidates for this procedure. The success of this surgery is dependent on proper knee alignment, ligament stability, and amount of articular cartilage that is present.
A collagen implant is also an option to replace the meniscus. The implant is stitched into place with the hope that your body's own cells will begin to regenerate new meniscal tissue by attaching itself to the porous surface of the implant. In this way, the implant works as a scaffold to assist the body with its own repair process.
If you want to Maximize the Chance
of Healing Your Meniscus,
You Really Do Need A Knee Inferno Wrap®
If you have undergone surgery on your meniscus injury then your physician will quickly get you on the path to rehabilitation. Now, the aggressiveness of your rehabilitation efforts and your injury's ability to heal will depend on a variety of factors including (but not limited to):
- your age, overall health and activity level
- the state of your injury before surgery (severe injuries like a tendon rupture, open wound, bone damage or fracture will require more intense surgery)
- the type of surgery you have undergone
- how soon you must return to normal activity
It is also important to keep in mind that no two meniscus injuries and surgical procedures are alike. So if you and a friend suffer from meniscus injuries at the same time, your rehabilitation after meniscus surgery is going to be completely different from that of your friend's. This is why rehabilitation plans need to be tailored to your personal needs. If you are consulting a physical therapist rather than your surgeon for rehabilitation, your physical therapist will need an account of your injury before the surgery and what was done during your surgery before properly creating a rehabilitation plan suited to your specific needs.
Rehabilitation and physical therapy efforts after a meniscal repair differ with two distinct schools of thought between orthopedic surgeons, doctors, and physical therapists. Some medical professionals will recommend a conservative method of rehabilitation, while others will offer accelerated guidelines for physical therapy.
For conservative treatment methods, patients are required to use rest, cold compression therapy, blood flow stimulation therapy, limit mobility and weight bearing on the affected knee until 4 weeks after the surgery. Range of Motion (ROM) exercises are also limited until 6 weeks after surgery, and a full return to a normal level of activity or sports training is not encouraged until 5 to 6 months after the surgery.
On the other hand, accelerated rehabilitation encourages early ROM and weight bearing and provides no limits for getting back to activity (this is more or less evaluated on a case by case basis).
There have been many studies comparing and contrasting the two techniques to find which is more effective and better for the body, however results in these studies vary resulting in no clear advantage of one technique over the other. The approach for rehabilitation after a meniscal repair is treated much like the orthopedic surgeon's decision for which surgical procedure will be selected - rehabilitation hinges on the age of the patient, condition of the meniscus pre and post surgery, and of course dedication of the patient to the rehabilitation program.
Your rehabilitation will be based on the type of surgery you have had. A meniscal repair surgery is usually longer healing with more restriction of movement than the rehabilitation after a partial meniscectomy procedure. Rehabilitation after open knee surgery is always more extensive than rehabilitation after an arthroscopic procedure, because open surgeries are more invasive. It is important to note that driving after a meniscal repair is usually not recommended by a doctor until you have full control of your knee back and do not need to take prescribed medication to manage your pain. You will typically have to wait 4 to 6 weeks after your meniscal repair to return to driving. This timeline will of course depend on whether your doctor has selected a conservative or aggressive plan for your rehabilitation.
A list of quick links to the types of surgery and post recovery:
MendMeShop Helped Me Avoid a $13,000 Meniscus Surgery
I am a 44 year-old woman in good health. I eat a fresh diet and take high-quality supplements, including MSM, glucosamine, Zyflamend, and all the usual joint-recomended supplements.
I injured both knees two years ago while kneeling to tile my family room and entry. Subsequently, a simple twisting squat ripped my left meniscus with a huge bucket tear that required surgery to trim so it wouldn't keep catching and re-tearing. I am not one to undergo surgery unless it is unavoidable, and even after a "simple" scope operation, it took me a full year to get full extension back on that knee, and I doubt I will ever be able to squat again.
I run a cleaning business. A couple of months ago an employee had forgotten to return equipment to my van, and I had to mop some hardwood flooring for a client on my hands and knees. That simple ten-minute job put me back out of commission. The kneeling pre-injured the area, and when I stepped back onto my good leg two days later, I felt that familiar burn of a fresh meniscus tear. I was heartsick, dreading another surgery and the attendant expense, pain, and down time. I know from my previous experience that cartilage is hard to heal because of the poor blood supply, especially to the center. I knew it was just a matter of time before I tore it further. (My dad had multiple knee scopes before finally getting a replacement, but I was not going down that path if I could help it!)
I got online and researched alternatives that would get me back on my feet. Delighted to discover Mend Me Shop and their professional athletic healing devices, I ordered the Inferno Wrap and Ice Wrap. $400 would be a pittance relative to the $13,000 it costs to repair a torn meniscus (and that doesn't include rehab and lost income). During the week it took the package to arrive, I stayed off my feet as much as possible and iced the injured knee several times a day. My big hope was simply to avoid tearing the cartilage further before the stuff came. (With my surgery knee, I had re-torn it repeatedly before surgery.)
The minute that I put that Inferno wrap around my bad knee, I was in love! The penetrating warmth felt amazing. I kept it by my desk and strapped it on when I would sit and work at the computer. And I kept icing the knee. Within a couple weeks I was walking evenly on both legs, if gingerly lest I inadvertently twist or bounce. But I was definitely healing. I didn't miss any work after the first week, though I moved more slowly than usual and occasionally felt that piercing reminder of the tear. I had to lie down and elevate my knee every two hours to get through the day, but it was slowly healing. Four weeks later I was feeling so good, and the day was so sunny, that I went skipping off the front porch and was reminded I have a torn meniscus!
And so it goes to this day, some six weeks later: the injury is there, but it is gradually improving. The more I use the therapy devices, the faster it improves. The more I get lazy and feel perfect and neglect them, the more I slow down. But I work a full schedule without breaks and only occasionally am reminded of the injury. By God's grace and with many thanks to Mend Me Shop, I have avoided surgery!
Debbie Morgan, Texas USA
Rating: [5 of 5 Stars!]
Results may vary. Always seek the advice of your physician
in choosing the best treatment option for you.
An open repair is rarely performed because arthroscopic surgical techniques are minimally invasive with a quicker rate of recovery and a better outlook for overall healing. If you have had an open knee surgery repair for your meniscus repair, you probably suffered from an acute trauma with an open wound over your knee, or your surgeon started an arthroscopic procedure and your injury was worse then he had told you. This change of plans for your surgery could have never been predicted.
You should expect your rehabilitation to be longer if you have had open knee surgery. You will not know the full extent of your rehabilitation unless your surgeon has given you a detailed rehabilitation plan after the surgery. It is entirely possible that you will go into your surgery expecting the rehabilitation time period of an arthroscopic procedure, and come out of your surgery having to follow a longer rehabilitation period for open surgery. Orthopaedic specialists do their best to diagnose your injury and plan for every stage of your surgery, but sometimes changes in their procedures are unavoidable.
What is known is that open knee surgery recovery can be similar to the recovery from a complete or partial knee replacement. Both procedures are invasive, require an incision 6 to 10 inches in length. You will have to stay in the hospital for a few days after your knee surgery, you are considered inpatient for surgery.
Phase 1, In-Hospital Recovery (Surgery to 4 days after Surgery) - While in the hospital, your knee will be checked on periodically to see your how your are healing. The dressing on the 6 to 10 inch incision will be changed, and any excess fluid (blood) will be drained from the dressing. You may be encouraged to move your foot and lower leg to increase localized blood flow and manage all swelling and inflammation in your knee. Your doctor and/or surgeon will also monitor the swelling and any evidence of blood clot formation as these are some of the major side effects experienced after extensive surgery of this kind.
During your hospital stay you may interact with a physical therapist to introduce simple knee exercising meant to prevent atrophy (wasting away) of your muscles while you are resting your leg.
Phase 2, Initial At-Home Recovery (5 days to 8 weeks after Surgery) - You will need to use crutches for approximately 4 weeks to reduce the amount of weight you are bearing on your affected knee/leg. This will help to protect the delicate work that has been done to fix the meniscal (and other) tissues in your knee as well as the outside skin incision(s). Your surgeon will recommend that you manage all post-surgical swelling with the R.I.C.E. (rest, ice, compression, elevation), as needed in the beginning, and then for 20 minute periods whenever pain and swelling are experienced.
Your leg/knee will be stiff and painful at first, and simple, easy movements may seem challenging in the beginning. Don't be discouraged! Your overall mobility will be much more reduced than you anticipate because of the 6 to 10 inch incision on your knee. Some of this pain and stiffness can be treated by increasing healthy blood flow to your knee before you exercise, with an Knee Inferno Wrap®. An Knee Inferno Wrap® will warm your tissue, reduce any lingering stiffness in your knee, and increase the amount of oxygen, nutrients, antibodies and energy that travel to your injured tissue. Physical therapy will progress with regular appointments (1 to 2 times per week) for the first 8 weeks after the surgery. Exercise and strengthening routines will be focused on regaining simply abilities, such as walking, and improving the strength, capability and ROM of your knee.
Using an Knee Inferno Wrap® for approximately 15 to 20 minutes (finishing 15 minutes before exercise or your physical therapy appointment) will warm up your knee, relax your thigh (quadricep) muscles and boost flexibility of your tissue. Your commitment to recovery will include your physical therapist requesting you to contininue your stretching at home to increase your rate of recovery. This is where Knee-Flex® comes in! The Knee-Flex® provides safe, consistent, controlled heel to hip movement on a sturdy, hardwood track. This makes sure that your heel slides are the same every time! Your stretch won't vary or change as you attempt a higher number of repititions, experience set-backs from re-injury, or lose control over unsafe household tools.
You may be able to return to driving approximately 4 to 8 weeks after the surgery. At the same time, you may also be able to return to other low-impact daily activities, such as walking or cleaning the house.
Phase 3, Gradual Return to Regular Use and Activity (2 months to 1 year after Surgery) - Physical therapy should continue for another few months (usually to at least 6 months) after the surgery with a gradual return to all activity. High-impact activities, such as jogging or sports of any kind, may not be appropriate for at least a year after your surgery. Your overall ability to return to your normal set of activities will be judged on an individual basis with your surgeon and/or physical therapist. After rehabilitation has ended, you will need to continue the management of your knee healing through regular exercise and conservative treatments. Back to the surgery list
What's Over Compensation Pain?
Everything in the human body is connected. Any meniscus injury can lead to other injuries over time if not treated properly. You might start limping on the leg of your injured knee and place more weight on your opposite, healthy leg. Limping your way around for a long period of time may lead to pain in the knee, hip or lower back on your injured side because you are mis-aligning your entire leg (keeping it straight and off to the side) to compensate for the injury.
Rehabilitation after an Arthroscopic Meniscal Repair Surgery
As there are two different approaches to meniscus surgery recovery - conservative or aggressive plan. We have provided both rehabilitation methods but it is up to you to discuss the pros and cons of each approach with your doctor, surgeon or physical therapist to find out which rehabilitation plan will work best to heal your meniscus.
Conservative Rehabilitation for Meniscal Repair
Phase 1, Initial Recovery after Surgery (Surgery to 6 weeks after Surgery) - The main goals during this phase are to protect the meniscus repair, control pain and swelling, and encourage maximum healing potential. Right after surgery your knee will be wrapped with a bandage to protect the small key-hole incisions made in the skin. During the first few days of recovery you will need to change your bandage regularly to prevent infection. Will not be able to get your knee wet in any way within the first 2 days after your surgery.
You will be required to use crutches when walking to reduce the amount of weight you are bearing on your affected knee. You may gradually reduce use of your crutches throughout Phase 1 of your rehabilitation. You will also need to wear a locked knee brace (fitted before your surgery) for all weight bearing activities and while sleeping. The use of crutches and a locked knee brace will provide maximum protection for your knee while your meniscus goes through its' natural healing process.
It is important during this time to regularly control your pain and inflammation with a cold compression therapy. Some doctors will refer to this cooling therapy as R.I.C.E. Applying cold to your knee will reduce pain by gently numbing the nerve-endings in your knee, and also slow down the inflammatory process effectively reducing swelling. While doing this the cold also stops cellular break-down and reduces the amount of scar tissue forming (this is very important after surgery).
Your doctor may suggest some light initial stretching to gradually introduce activity back into your routine. Light stretching may include active-assisted range of motion exercises like extending your knee, flexing your knee, raising your leg (quadriceps sets) or sliding your heel away from your body (heel slide). Your commitment to recovery will include the stretching at home to increase your rate of recovery. This is where Knee-Flex® comes in! The Knee-Flex® provides safe, consistent, controlled heel to hip movement on a sturdy, hardwood track. This makes sure that your heel slides are the same every time! Your stretch won't vary or change as you attempt a higher number of repititions, experience set-backs from re-injury, or lose control over unsafe household tools. Any exercises undertaken during rehabilitation must be cleared with your surgeon and physical therapist. If your surgeon has recommended the use of a physical therapist, you can expect to have regular weekly appointments scheduled during this Phase.
During this Phase you will likely have a follow-up appointment with your surgeon to assess the progress your meniscus has made in healing after the surgery. Depending on the type of amount of repair done, you can be increase your healing power with the use of Blood Flow Stimulation Therapy™ (BFST®), nourishing and strengthening the tissue in your knee is the goal. BFST® promotes blood flow to the treatment area bringing the necessary oxygen and nutrients to your meniscus and other weakened tissue. BFST® speeds up the body's natural repair process for faster healing and stronger tissue.
Your doctor will advance you to the next Phase of rehabilitation when you can walk pain free without the aid of crutches and there is no evidence of inflammation or swelling in your knee.
Phase 2, Increase ROM and Weight Bearing (6 weeks to 3 months after Surgery) - Conservative rehabilitation will focus on gaining back your range of motion (ROM) and increasing your ability to bear weight on your leg. You may still be expected to wear a hinged knee brace, but it will no longer be locked.
You will start gradually moving your knee in a free (non-forced) way with very low-impact exercises. Including flexing of your knee, stationary bicycling, and strengthening of your leg muscles (quadriceps, hamstrings, thighs and calves). Many of these exercises will be geared to improving balance and strength within your hips and core. While building your ROM and strength in the muscles surrounding your knee will help to increase stability of your entire leg while healing.
You can expect to continue your regular physical therapy appointments approximately once every 1 to 2 weeks. It will be important that you completely dedicate yourself to your rehabilitation by stretching and exercising at home as well. Your physical therapist or doctor may give you specific guidelines for performing or adapting your physical therapy exercises at home.
Controlling post-exercise swelling and inflammation is crucial during this Phase. Any sign of swelling or inflammation after exercise is a sign of minor re-injury to your knee or surrounding muscles. Controlling your inflammation immediately after exercise for at least 20 minutes with a cooling therapy will prevent any chance of re-injury to your meniscus. If you are not conscious of this, a set-back at this point could result in additional tearing of your meniscus.
Your doctor will advance you to the next Phase of conservative rehabilitation once you are able to walk normally, show measured improvement with your ROM and demonstrate improved function and balance on your knee.
Phase 3, Optimize Full Capability of Your Knee (3 months to 6 months after Surgery) - Your physical therapist or doctor may increase the number of repetitions that you must do for each stretch, and they may also introduce resistance or weight to your exercising. The goal of this Phase is to imitate movement and demands required of your body on a normal daily basis. This goal will be different for everyone. If for example you are an athlete, your physical therapist will likely introduce activity or drills that re-condition your knee for the sport that you're involved in. If you are not an athlete, your exercises will be more geared toward your personal level of activity based on any job-related or lifestyle demands that are placed on your body.
You will still need to keep your regular physical therapy appointments 1 to 2 times per week. You must also continue to control any post-exercise swelling and inflammation. Eventually, as your knee heals, you will experience decreased amounts of post-exercise swelling. Even if you do not immediately feel or notice any amount of inflammation after activity, you should still apply cold compression therapy to eliminate any risk of recurring inflammation. Eliminating your inflammation encourages your body to heal quickly and efficiently.
Your doctor will advance you to the next Phase of rehabilitation once you are capable of full ROM and control of your knee without evidence of pain or swelling.
Phase 4, Return to Regular Use & Activity (6 months after Surgery and Beyond) - After 6 months of successfully conservative rehabilitation your doctor will clear you for a full return to athletic and work activities. At this point you may have less involvement from your doctor of physical therapist. They may recommend occasional check-ups or appointments to assess your injury, but the responsibility of monitoring your progress will likely fall on your shoulders. After your rehabilitation has ended, you will need to keep a watchful eye on activity performed with your knee and address any signs of re-injury as soon as they occur. Back to the surgery list
We have tools that will help you with post-surgery meniscus pain, healing and stretching. When it comes to your injured knee, it's best to start effective long term healing right away. Our Advisers are highly trained individuals and will help find the long term healing goal that's right for YOU. Why wait?
Call today and get on the road to recovery faster than ever before!
Call now! Toll Free: 1-866-237-9608
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Accelerated (Aggressive) Rehabilitation for Meniscal Repair
Phase 1, Initial Recovery after Surgery (Surgery to 1 weeks after Surgery) - Protect your knee after surgery, control pain and swelling, start gentle movement of your knee and strengthen your quadriceps muscle. Your knee will be bandaged and you will need to change your bandage regularly to prevent infection at the site of your incisions. You may be fitted for crutches before the surgery, and will be expected to use these along with a locked knee brace for the first week after your surgery.
You will be encouraged to bear as much weight as you can handle on your knee while walking with the crutches. Controlling pain and inflammation with a cold compression therapy is important to stimulate healing of your meniscus and allow you to incorporate regular stretching. Your doctor may refer to this as R.I.C.E. Using a cold compression therapy will be important throughout the accelerated rehabilitation plan, because you will need to be sure to control any inflammation that occurs due to your exercising, stretching and strengthening routines. Inflammation could be a sign of re-injury to your meniscus; this is why cold compression therapy will be important especially when it is applied after activity of any kind (exercising or extra walking around). You should apply cold for 15 to 20 minutes at a time as needed to reduce pain and inflammation.
Your doctor will start you off with gentle stretching of your quadriceps muscle. Some other exercises that your doctor may recommend include: extending of your knee by propping your heel up on furniture (heel prop), sliding your heel away from your body while in a seated position (heel slide), or flexing your ankle to stimulate circulation in your leg (ankle pump).
There may be some overlap between the 1st and 2nd Phases of accelerated rehabilitation. Your doctor or surgeon will likely schedule a post-operative check-up within 10 to 14 days after your surgery. For some, this will extend your 1st Phase of rehabilitation, for others your doctor may have already given you specific instruction about moving forward through your rehabilitation. Either way, your doctor will assess the healing progress of your meniscus at your appointment and discuss your rehabilitation plan so far.
Phase 2, Increase ROM and Weight Bearing (1 week to 5 weeks after Surgery) - You will begin to focus on regaining your ROM and begin more in muscle strengthening. Controlling inflammation and swelling is still a key in this Phase, as increased motion without proper use of cooling therapy may put your meniscus at risk for re-injury. Blood Flow Stimulation Therapy™ via a Knee Inferno Wrap® for approximately 15 to 20 minutes (finishing 15 minutes before exercise or your physical therapy appointment) will warm up your knee, relax your thigh (quadricep) muscles and boost flexibility of your tissue and reduce any chances of re-injury to the delicate repair done on the meniscus. This boost of blood to the tissue will increase your natural healing and take full advantage of all the energy and hard work you are putting into your exercises.
You will be encouraged to continue using crutches when walking, and your knee brace will probably remain in a locked position. As with Phase 1, you will be able to bear as much weight as you can tolerate on your affected leg as long as you are using the crutches and knee brace as directed. The crutches will continue to help you distribute weight away from your affected leg, so you can continue to protect your meniscal repair throughout rehabilitation.
At this point if your doctor or surgeon feels a physical therapist will be a good time for your rehabilitation, you will likely have regular appointments 1 to 2 times per week. Your exercise plan will include stretches mentioned in Phase 1 along with new stretches focused on tightening the muscles in your leg and increasing range of motion. This may also include more involved quadriceps stretching, increased extension of the knee, gentle squats using the support of a wall or other equipment, and maybe even a stationary bicycle if your ROM has improved to a satisfactory level. Any hamstring stretches, deep squats or activity that requires twisting of your knee should be avoided. Your doctor or physical therapist will also encourage you to continue the set of approved stretches at home as directed. Consistent movement both in your appointments and at home is crucial for the accelerated rehabilitation plan.
You will advance to the next Phase of accelerated rehabilitation once your doctor of physical therapist feels you have marked improvement in your ROM.
Phase 3, Optimize Full Capability of Your Knee (5 weeks to 10 weeks after Surgery) - Your doctor or physical therapist will increase your activity level in order to regain full ROM and muscle strength in your leg. You may be able to stop using your crutches at this point if your doctor feels you have healed enough to bear more weight on your leg. It is important, if you are not going to be using the crutches any longer that you focus on walking slowly and normally. Limping should be avoided at all costs, as abnormal walking could result in re-injury of your meniscus or injury to your opposite leg, feet, hip or even your back with overcompession injury/pain. You should also avoid squatting or pivoting on your injured knee.
Continued use of R.I.C.E. as a cold compression therapy will be recommended, especially after activity, in order to control your pain and inflammation. This therapy may be recommended 2 to 3 times per day for 15 to 20 minutes at a time.
Your exercise will be increased to include regular use of a stationary bicycle, or you may even be introduced to a pool program which will require running and exercising in the pool. Using a pool for rehabilitation is common, as the pool will shift your weight effectively reducing the amount of weight you are bearing on your affected knee during more complex movement. Stretching will continue to include stretches mentioned in both Phase 1 and 2 of this rehabilitation plan, but may also expand to include lunges, hamstring curls, and movement of your hip. The number of your stretches will have increased since Phase 1, and will continue to increase in order to regain full ROM and strength in your leg.
You will advance to the next Phase of rehabilitation once your doctor or physical therapist feels you have regained full ROM without pain in your knee. You must also have no pain or tenderness in your knee and may need to pass a clinical exam or a test of your muscular strength.
Phase 4, Return to Regular Use & Activity (10 weeks after surgery and beyond) - Your doctor or physical therapist will clear you for a return to work or athletic activity. It will be recommended that you continue your muscle strengthening and stretching in order to maintain healthy ROM of your knee. Pivoting and twisting on your knee should still be avoided when possible as your meniscus is still healing. Additional cardiovascular exercise will also be encouraged such as 20 to 30 minutes on a tread mill, stationary bicycle, elliptical trainer, or swimming approximately 5 times per week.
If you are an athlete, you may not be able to return to full athletic training until 6 months after the surgery. Your doctor of physical therapist will likely advise a gradual return to your previous athletic training or exercising regimen. Back to the surgery list
We have tools that will help you with post-surgery meniscus pain, healing and stretching. When it comes to your injured knee, it's best to start effective long term healing right away. Our Advisers are highly trained individuals and will help find the long term healing goal that's right for YOU. Why wait?
Call today and get on the road to recovery faster than ever before!
Call now! Toll Free: 1-866-237-9608
International: +1 705-445-3505
A very straight forward rehabilitation plan is given, as there is no need to protect your knee from further damage because your surgeon has not done a to fix your meniscus. Instead, has removed any displaced or torn tissue in your knee to eliminate your symptoms (popping, locking or clicking of your knee) and improve overall functionality. Early rehabilitation can focus on gaining back range of motion (ROM) as quickly as possible.
Driving after a partial meniscectomy surgery is usually not recommended by doctors until 1 to 2 weeks into rehabilitation. As with any rehabilitation plan, it's important that you consult your doctor, surgeon and/or physical therapist to find out what type of plan will suit your knee and body after your surgery.
Phase 1, Immediate (Acute) Post-Operative Phase (Surgery to 10 days after Surgery) - The main goals during this Phase of rehabilitation are to reduce inflammation and swelling, restore range of motion and strengthen the quadriceps muscle(s). After a partial meniscectomy surgery improving blood flow function is crucial to reduce the amount of long-term degeneration to your remaining meniscal tissue.
You may wear a brace, but it is generally not required by most doctors or surgeons. You should be able to move around relatively pain free soon after the surgery but may require the use of crutches for your first week of rehabilitation. Your doctor or surgeon will recommend the use of a cold compression therapy such as R.I.C.E. to reduce pain, inflammation and swelling. Stretching will start early, may even be the day after your surgery and you will first focus on movement of your quadriceps muscle, hips and gentle extension of your knee. You will be encouraged to bear as much weight as you possibly can, comfortably, on your affected knee (with the aid of crutches if needed).
As recovery progresses, stretches may increase in number of times and you will be able to gradually stop use of your crutches. You may only use crutches if absolutely necessary, and limit use to one crutch mid-way through Phase 1 of rehabilitation. Eventually, by the end of this Phase, you will be expected to walk normally (no limping) without the aid of crutches. Limping early on in your rehabilitation is likely to cause compensation pain in your opposite healthy leg, knee, hip and/or back. Limping should be avoided at all costs during rehabilitation.
Your doctor, surgeon or physical therapist will move you onto the next Phase of rehabilitation once you have effectively reduced your pain and swelling with a cold compression therapy, and show improvement in your range of motion and stretching capability.
Phase 2, Intermediary Post-Operative Phase (10 days to 4 weeks after Surgery) - By the end of this Phase in rehabilitation you will be able to have full pain-free range of motion, improved muscle function, and can return to some of your daily activities (work and/or light exercise). Your stretching and strengthening routines will expand to include lunges, squats, full knee extension, hamstring curls, hip movement and balance training. As you progress through this Phase of rehabilitation, your doctor or physical therapist will tweak your stretching and strengthening routine to decrease the number of repetitions for each stretch and instead increase the amount of weight used. Your doctor, surgeon, or physical therapist may integrate a pool program for more intensive running and leg movement, to decrease the amount of weight placed on your knee joints.
A therapy such as Blood Flow Stimulation Therapy should be incorporated before exercise to increase localized blood flow in your knee. This will relax muscles and tendons providing enhanced muscular flexibility. You should also continue to use a cold compression therapy, such as R.I.C.E., to manage pain and swelling occurring after exercise.
Before progressing to the final Phase of rehabilitation for partial meniscectomy surgery, your doctor or physical therapist will expect that you have full pain-free range of motion, absolutely no evidence of swelling or inflammation, and you may be required to pass clinical tests or exams.
Phase 3, Return to Regular Use & Activity (4 weeks after Surgery and Beyond) - After 4 weeks of focued rehabilitation for your partial meniscectomy surgery your doctor, surgeon or physical therapist will clear you for a return to all normal activity. You will be need to continue exercise, stretching and strengthening of your knee and surrounding leg muscles in order to maintain full ROM. If you are an athlete, you will likely undergo additional rehabilitation to achieve a gradual return to full athletic activity. Back to the surgery list
It may seem hard to believe
Regardless of what type of meniscus surgery you have undergone (or even no surgery at all), our Knee Freezie Wrap®, Knee Inferno Wrap® and Knee-Flex® Passive Knee Stretch Device home therapy products will assist you in recovering from your injury faster and reduce the chance of degenerative knee conditions by maximizing blood flow where it is needed most, reduce swelling and inflammation induced pain as well as allow you to gently stretch your injured knee without risking further injury.
Conservative treatment of your meniscus tear is to reduce the swelling to "open up" the area for more blood flow. Anyone in the health-care business knows that your blood supplies the oxygen and much needed nutrients required to heal any soft tissue injuries. This is why for years doctors, trainers and other medical professional have recommended RICE (Rest, Ice, Compression, Elevation) to treat the pain and swelling of fresh injuries, chronic pain, and after any re-injury.
Your natural pain reliever - Cold Compression Therapy
Although RICE can help to treat these symptoms, ice and freezer gel packs reach temperatures so low they can cause cryoburn, an ice burn on your skin. The problem is, up until now there hasn't been any other option to treat painful conditions and injuries, so ice and blue gel packs (full of anti-freeze and chemicals) have been the only choice up until now.
Fortunately you no longer have to settle for these ice cold methods that are uncomfortably cold against your skin, provide short term relief, cause ice burns, numb your skin and underlying tissue beyond feeling so you don't even notice the ice burn until it's too late and pool around your injury putting the cold everywhere except for where you need it most.
A Freezie Wrap® allows you to treat your meniscus in an effective and convenient way. Our Freezie Wraps® will wrap around your knee keeping the cold right over your injury for the entire length of your treatment. Our food-grade, non-toxic gel packs can be chilled in the fridge or freezer to tailor the amount of cold that you need for your injury. It doesn't matter how you cool it down, because our gel packs are chock full of gel that's designed to cool down into millions of tiny snowflakes. The cushioned gel will wrap around your knee and it won't budge for the entire treatment period. You'll no longer have to deal with annoying pooling around your knee injury or have to hold a hard block of ice on your knee!
Improve Circulation, Soften Scar Tissue & Prevent Re-Injury with Blood Flow Stimulation Therapy
Once inflammation and swelling have been reduced in your knee, nourishing and strengthening the tissue in your joint is the goal. Blood Flow Stimulation Therapy™ (BFST®) promotes blood flow to the treatment area bringing the necessary oxygen and nutrients to your meniscus and other weakened tissue. BFST® speeds up the body's natural repair process for faster healing and stronger tissue.
Remember, the meniscus is cartilage and does not receive much blood flow naturally and when you rest your knee, you are not creating the natural blood flow your knee usually receives. With the use of Blood Flow Stimulation Therapy™ you can increase your bodys blood supply to the knee and healing power.
In addition, the fresh blood flow whisks away dead cells and toxins (including lactic acid, commonly found in trigger points) that have built up from the injury leaving the area clean and better prepared for healing. Our Knee Inferno Wrap® provides effective, non-invasive, non-addictive pain relief with no side effects.
Keeping your knee as healthy and strong as possible throughout the healing process will allow you to get back to your regular activities faster. The Knee Inferno Wrap®, available exclusively from MendMeShop®, provides effective, non-invasive, non-addictive pain relief and healing with no side effects.
The benefits of BFST® do not end once your knee pain stops! Even when your meniscus has healed, your activities can put your knee at risk of an overuse injury, tightness, or another tear. An Inferno Wrap® treatment before activity is an easy way to flood the area with fresh nutrient and oxgyen, tissues soft and flexiable and ready to use. Then, end your day with another treatment to prevent tightness from setting in overnight. This incredible healing tool will help you have a healthy knees for years to come!
During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your knee until your pain and inflammation settle. With these easy home therapies you will notice great improvement within a few weeks, with most meniscus patients seeing some improvement quickly. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results. If you start using your knee before it has a chance to heal properly (even though it may feel better), you can end up doing a lot more damage than good!
Prevention and Promotion of Lifelong Health
If you want to avoid re-injury, or manage pain and increase circulation for lifelong health benefits. A Knee Freezie Wrap® and Inferno Wrap® will provide the results you are looking for.
Why spend time in pain, off from work, and missing out on your active lifestyle when you can be proactive about your injury and the health of your body? Talk to your doctor about incorporating a regular routine of using a Freezie Wrap® and Blood Flow Stimulation Therapy™ into your everyday health regimen.
If you are still uncertain which route to go or if you would like to discuss issues affecting your meniscus, acl, mcl or other knee injuries, then do not hesitate to contact a AidMyMeniscus Advisor immediately by phone or email.
North America Toll Free 1-888-995-3505
Outside North America 1-705-445-1765
Monday to Friday 8:00 am to 9:00 pm (Eastern Standard Time)
Saturday & Sunday 11:00 am to 6:00 pm (Eastern Standard Time)
AidMyMeniscus advisors do not work on commission, so be assured you will only receive fair and objective information.
Click here to read more about how the Knee Inferno Wrap® helps with the healing process.
Click here to read more about how the Knee Freezie Wrap® is designed to be the most effective cold compression wrap on the market today.
Click here To read more about why the Knee-Flex® Passive Knee Stretch Device is a proven knee therapeutic device that is currently in use in hospitals and therapists clinics in Canada.